Why modern rhytidectomy techniques deliver better results
The history of modern facelifts begins in Berlin, Germany in 1901. Eugen Holländer was approached by an aging woman with a curious request. The Polish aristocrat wanted to have her cheeks and the corners of her mouth “lifted” as a method of restoring her youthful features. After considerable debate, Holländer agreed and the era of cosmetic surgery was born.
A brief history of the facelift
As you might imagine, our understanding of rhytidectomy (a combination of the ancient Greek words for “wrinkle” and “excision”) has blossomed over the past century. The procedure evolved from simply cutting and pulling to exploiting the Superficial Musculoaponeurotic System (SMAS) to achieve natural looking restoration. Here’s a quick look at how far we’ve come.
The Cutaneous period. For decades after Holländer’s first lift in 1901, most rhytidectomies only involved addressing the skin. In 1917, Dutch plastic surgeon Dr. Johannes Esser discovered the first major advancement in facelift surgery while operating on soldiers wounded in World War I. Dr. Esser began using dental stents to restore the structure to facial features, a technique that flourished in the following six decades.
Superficial Muscular Aponeurotic System (SMAS) period. By the late sixties, it was time for another evolutionary step. Swedish surgeon Dr. Tord Skoog is credited with introducing subfascial dissection in 1968. Skoog developed a more organic restorative effect by lifting the deeper system of soft tissue and muscle rather than simply addressing the skin.
Deep plane period. If going beneath the skin was better, then why not try going all the way to the bone? In 1979, French plastic surgeon Paul Tessier decided to do just that. The results of his subperiosteal (below the cranium’s outer membrane) lift introduced a new convention in cosmetic surgery.
Volumetric period. Today, we understand subperiosteal as an only-when-necessary technique. By the beginning of the 90s, cosmetic surgery became more focused on restoring the soft tissue in the lowest layer of the skin—subcutaneous tissue. New techniques also placed more emphasis on the direction and amplitude, or “vector,” of the lift.
Why today’s facelift techniques are superior
Aside from looking more refreshed and youthful to acquaintances, friends, and family, nobody should be able to tell you’ve had a facelift. Each advancement throughout the years has been driven by the quest for the most natural restoration technique.
Focusing on the subcutaneous tissue and using appropriate SMAS techniques are almost like turning back the clock. Instead of the more invasive and artificial approach of creating volume where it doesn’t belong or dramatically tightening skin, proper modern techniques provide significantly more organic results.
We also have a better understanding for how vector affects the outcome of the procedure. A carefully-gauged angle – typically around 45 degrees but weighted more toward a vertical rather than a lateral orientation – tends to preserve fullness in the cheeks, improves jawline definition, and generates a seamless transition between the eyelid and cheek.
Finding a cosmetic surgeon you can trust in South Florida
The decision to undergo cosmetic surgery can be difficult. It’s important to engage with a surgeon you trust and one who takes the time to understand your desired results.
Board-certified plastic surgeon Dr. John Michael Thomassen has been rejuvenating South Florida for over a decade. Dr. Thomassen and his staff welcome the questions and concerns of each patient—our goal is to provide exceptional service, support, and care.
If you’re considering a facelift or other cosmetic procedure, we encourage you to schedule a consultation at your convenience.
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